Challenges of Interpreting Results From Analyses That Use Extensive Claims Data
Authors: Andrew D. Auerbach
Journal: Annals of Internal Medicine (2009)

Letters15 December 2009Challenges of Interpreting Results From Analyses That Use Extensive Claims DataAndrew D. Auerbach, MD, MPH, Michael B. Rothberg, MD, MPH, and Peter K. Lindenauer, MD, MScAndrew D. Auerbach, MD, MPHFrom University of California, San Francisco, San Francisco, CA 94143-0131; and Baystate Medical Center, Springfield, MA 01199.Search for more papers by this author, Michael B. Rothberg, MD, MPHFrom University of California, San Francisco, San Francisco, CA 94143-0131; and Baystate Medical Center, Springfield, MA 01199.Search for more papers by this author, and Peter K. Lindenauer, MD, MScFrom University of California, San Francisco, San Francisco, CA 94143-0131; and Baystate Medical Center, Springfield, MA 01199.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-12-200912150-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Lobdell and colleagues point out the challenges that are inherent to interpreting results from analyses using highly detailed claims data. Although our approach did not specifically exclude patients receiving amiodarone or pressors, it did exclude patients with a wide range of contraindications (hypotension, heart failure, and bleeding). Nevertheless, we may have misclassified a few of the patients with acceptable contraindications, perhaps partially explaining the inconsistent relationship between individual measures and mortality. However, it is less obvious how misclassification would produce a strong association between overall quality and improved outcomes.Although our risk adjustment models did not contain ...Reference1. Pine M, Jordan HS, Elixhauser A, Fry DE, Hoaglin DC, Jones B; etal;. Enhancement of claims data to improve risk adjustment of hospital mortality. JAMA. 2007;297:71-6. [PMID: 17200477] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of California, San Francisco, San Francisco, CA 94143-0131; and Baystate Medical Center, Springfield, MA 01199.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoShop for Quality or Volume? Volume, Quality, and Outcomes of Coronary Artery Bypass Surgery Andrew D. Auerbach , Joan F. Hilton , Judith Maselli , Penelope S. Pekow , Michael B. Rothberg , and Peter K. Lindenauer Challenges of Interpreting Results From Analyses That Use Extensive Claims Data Kevin W. Lobdell , Eric Skipper , Mark Reames , R. Mark Stiegel , Jeko Madjarov , Sara Camp , Francis Robicsek , and Sotiris Stamou Metrics 15 December 2009Volume 151, Issue 12Page: 895KeywordsConflicts of interestDiagnosis related groupsHealth care qualityHeart failureHemorrhageHypotensionMortalityStatistical dataSurgeons ePublished: 15 December 2009 Issue Published: 15 December 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...